糖尿病肾病尿蛋白标记物的临床意义以及中药的干预作用  

Clinical implication of urinary protein markers in diabetic nephropathy and interventional effects of Chinese herbal medicine

作　　者：史喜苗[1] 孟宪杰[1] 万毅刚[2] 沈山梅[2] 罗浔阳[2] 顾刘宝[3] 姚建 

机构地区：[1]南京中医药大学中西医结合鼓楼临床医学院,江苏南京210029 [2]南京大学医学院附属鼓楼医院,江苏南京210008 [3]江苏省老年医学研究所,江苏南京210024 [4]Department of Molecular Signaling University of Yamanashi,Japan Yamanashi 409-3898

出　　处：《中国中药杂志》2014年第14期2589-2594,共6页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金面上项目(81374030);南京市卫生青年人才培养工程项目

摘　　要：在临床上,有一些尿蛋白标记物(urinary protein makers)可以动态而无创伤性地反映糖尿病肾病(diabetic nephropathy,DN)患者肾小管损害的程度。这些肾小管性尿蛋白标记物大致分为2类,一类为新发现的尿蛋白标记物,包括尿肾损伤分子-1(kidney injury molecule-1,Kim-1)、尿中性粒细胞明胶酶相关脂质运载蛋白(neutrophil getatinase-associated lipocalin,NGAL)、尿肝型脂肪酸结合蛋白(liver-type fatty acid-binding protein,L-FABP)和尿半胱氨酸蛋白酶抑制剂C(cystatin C,CysC)等;另一类为经典的尿蛋白标记物,包括尿β2微球蛋白(β2 microglobulin,β2-MG)、尿视黄醇结合蛋白(retinal binding protein,RBP)和尿N-乙酰-β-D-氨基葡萄糖苷酶(N-acety1-β-D-glucosaminidase,NAG)等。这些异常增高的尿蛋白标记物不仅与DN患者肾小管上皮细胞损伤密切相关,而且,可以被一些中药复方或单味中药制剂所改善。近年来,尽管尿蛋白质组学(urinary proteomics)技术被运用于尿液蛋白质的分离和鉴定,然而,临床上传统的尿蛋白标记物联合检测技术还是更为实用的。目前,经典的肾小球/肾小管源性标记性尿蛋白的联合检测可能是揭示DN患者尿蛋白标记物临床意义以及中药干预作用的可行性措施。In clinic,some urinary protein makers can dynamically and noninvasively reflect the degree of renal tubular injury in patients with diabetic nephropathy（ DN）. These urinary biomarkers of tubular damage are broadly divided into two categories. One is newfound,including kidney injury molecule-1（ Kim-1）,neutrophil getatinase-associated lipocalin（ NGAL）,1iver-type fatty acidbinding protein（ L-FABP） and cystatin C（ CysC）; the other one is classical,including β2 microglobulin（ β2-MG）,retinal binding protein（ RBP） and N-acety1-β-D-glucosaminidase（ NAG）. It is reported that,the increases in urinary protein markers are not only closely related to the damage of tubular epithelial cells in DN patients,but also can be ameliorated by the treatment with Chinese herbal compound preparations or Chinese herbal medicine. Recently,although urinary proteomics are used in the protein separation and identification,the traditional associated detection of urinary protein markers is more practical in clinic. At present,it is possible that the associated detection of urinary biomarkers of glomerular and tubular damages may be a feasible measure to reveal the clinical significance of urinary protein markers in DN patients and the interventional effects of Chinese herbal medicine.

关 键 词：糖尿病肾病 尿蛋白标记物 肾小管损伤 临床检验 中药药效 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]